End of Shift Report - Stories From an Operating Room

Compelling, thought provoking stories and one man's inner and outer journeys from a devastating injury. These tales take you behind the doors of the reality of the OR and into some worlds of fantasy as well.
Use the Archives sidebar to jump to July 2012 to read a sample of the e-book available on Amazon, The I-bookstore, Lulu.com and Barnes&Noble .com
I have begun to add opinion pieces on hot! hot! topics in nursing as well.

Monday, November 3, 2014

My hat is off to Kaci HIckox. She volunteered to go to Africa to help fight Ebola, and thus help keep it from our shores. She then struck a blow for our own political freedoms by exposing many politicos, pundits and three Governors for the fear mongering, anti-science, vindictive bullies they are at heart.
Chris Christie, you say you will go to"any length" to protect the citizens of New Jersey from Ebola. That is not your job, it is the job of the New Jersey State Department of Health. You and all the other medically and scientifically challenged authorities should stand down and let the qualified professionals do their job.
Our nation has a sorry history of trampling the constitutional rights of the citizenry when fear mongering politicians and the media stoke up the worst instincts of people. The internment of Japanese-American citizens during WWII, the excesses of the McCarthy paranoia and the "Patriot Act" all come to mind. Now the threat is from "Ebolanoia".
A story comes to mind: A man is walking down the street, snapping his fingers in rapid succession. Another man asks him "Why are you doing that?" The first man replies "To keep the Elephants away". The second man says "But there are no Elephants within thousands of miles of here!" To which the first man says "Works pretty well, doesn't it!"
The internment of the Japanese Americans proved to be unnecessary and wrong, as did the anti- communist fervor of the early fifties. If the truth be told, the worst measures of the Patriot Act will prove just as ineffective, and just as wrong. Yet our precious freedoms and liberty have been eroded and damaged, perhaps beyond repair.
Kudos to Kaci for a blow for rationality in the face of fear!

While you are here, scroll down or jump to July 2012 and read a sample of the book "The End of Shift Report". Thank you for visiting!

Friday, October 24, 2014

I am very pleased with the news that both of the nurses who contracted Ebola in Texas have made recoveries. It has become apparent that health care workers, and nurses in particular, are the individuals most at risk during outbreaks of infectious diseases such as Ebola.
There has been much discussion in the literature of infectious diseases concerning the course of a hypothetical large scale outbreak of Ebola here in the USA as opposed to what has actually been seen i Africa. The speculation is that the mortality rate would be a great deal lower here for several reasons:
1. Hygiene. The limitations on the supply of clean water make a western standard of hygiene difficult, if not impossible, most places in Africa. This makes handling of patients far riskier.
2. Nutrition. A well nourished person has an immune system far more capable of fighting off Ebola.
3. Co-morbidities. The presence of other disease processes would make Ebola more likely to be fatal. Take for example Malaria. It is estimated that at any given time, 30 to 40% of the population in west Africa is carrying Malaria.
4. Cultural practices in caring for family members who are ill and in dealing with the dead make the spread of Ebola more likely in west Africa than here.
5. The supportive care (IV hydration, parenteral nutrition, etc) available to an Ebola victim here is vastly superior to west Africa. Supportive care gives the body a better chance of overcoming the virus.
The medical people in these discussions are estimating that the mortality rate would be in the range of 20 - 30 %. Still a very scary number, but nowhere near the 40 - 60% that has been seen in Africa.
Another concern is that many health care workers would simply not show up for work in the event of a major outbreak. The level of risk in west Africa is actually greater than in front line infantry engaged in combat. Nurses are not soldiers, and have not signed on for those sort of odds of survival.
Food for some serious thought. It does not have to be Ebola. There have been outbreaks of influenza with similar morbidity and mortality, the Spanish Flu that broke out just after WW1 for example.

While you are here, please scroll down and read a sample of the Book "The End of Shift Report". Thank you for visiting!

Monday, October 20, 2014

Texas Health Presbyterian Hospital (THPH) has apologized to it's community for the mishandling of the Ebola patient. Missing, however, is any apology to the nurses who work there for the chaos, incompetent management and lack of leadership that led to two nurses getting infected and more than forty confined to their homes in quarantine. Accountability? I thought that what admins are paid the $$ and why they get the perks.
The CDC says it is revising its protocols for PPE (Personal Protective Equipment) for nurses caring for Ebola patients to include 100% coverage of skin and hair with impermeable material and the process for removing it. Not to mention how to handle the infectious waste. About time. Do the nurses get an apology from the CDC?
How about the Lab worker from THPH that was confined to her cabin for the duration of the vacation cruise she was on?
The message we get is that health care workers are "little people" who do not count and are expendable, and hey, taking those kind of risk is what they get paid for, right?

While you are here, please scroll down or jump to July 2012 to read a sample of the book "The End of Shift Report". Thank you for visiting!

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Copyright registered 2011. This is a work of fiction. Any resemblance of these characters to any persons living or dead, or any actual situations or events is coincidental. This is a work in progress, and new chapters will be posted periodically.

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